| NPI | 1285834945 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X Radiology, Radiation Oncology (Licence: CO dR0057091) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: CA A120492) |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2019-03-12 |